Archived: Independent Options Central Support Service

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this service. This key question has been rated Requires Improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to person-centred care.

This service scored 45 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

Staff were found to be well intentioned towards people. However, some of the interactions with people were mostly transactional and task based. Staff did not always understand or know how to recognise or support people’s individual needs. For example, we saw one person who had a painful leg. However, staff only acted when we told them about this as they failed to acknowledge what the person was communicating to them. We also observed however, a staff member who was providing reassurance to a person as they did not feel well.

We have received mixed feedback from people’s relatives regarding staff and the care they were providing. Some of people’s relatives told us staff did not always know the people they were supporting and communication with people was affected when English was not their first language. One relative told us, “The boys have trouble understanding them, they are good, but communication is difficult.” Another relative told us, “Yes, they are all kind and caring.”

Some stakeholders shared their concerns regarding people’s care and rapport with people. One stakeholder told us, ”A significant safeguarding concerns was raised when an unknown staff member was assigned to a person without family consultation and this severely affected person’s mental health.”

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff did not always understand people’s individual preferences to respond appropriately. People’s care plans were not always person-centred and there was very little information for staff to support people to meet their goals and objectives. For example, one person had a high level of sensory needs and meeting these was important to the person. However, there was no information within the person’s care plan how these were addressed by staff. During our visit we observed people were served the same food and they were not given any choice as to what they wanted to eat or drink. For example, one person asked for a juice with their meal, but staff gave them water instead. We received mixed feedback from relatives. One relative told us, “Yes,

they know my loved one now, but they haven’t always.” Another relative told us, “Most staff have got to know my loved one and their ways. The new ones [staff] will observe him.”

Following our feedback the provider had taken prompt action to address the concerns raised during this assessment.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

People and their representatives were not always provided with opportunity to give feedback and engage in decision making about their care and support. One relative told us, “We would like more contact with the management, we have been told in the past we were too critical so it can be difficult. Our loved one is happy and 90% of things are good but we would like to know more and be involved though.” Another relative told us, “I would like them to do picture cards for them on a ring with options on, it’s the little things that would make a difference to them.” People with communication difficulties did not always have clear communication plans in place to support them to speak up and express their choices. Staff was well intentioned towards people they were supporting. However, staff did not always include people in their care and at times did not offer them choices and control. For example, we observed staff moving people who were in their wheelchair without asking if they were happy to be moved or where they wanted to go.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Staff did not always recognise when people needed support and assistance. For example, we saw one person who was getting distressed during their meal. However, staff failed to provide reassurance and support. This resulted in the person refusing their meal. This person was at risk of malnutrition. Another person was in pain and staff sitting next to them only recognised it when we pointed it out to them.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff had very little opportunity to provide feedback. Staff did not receive regular appraisals and supervision and had no access to regular staff meetings. Staff told us they did not always receive support when required for example, during out of hours. One staff member told us, “The office sometimes won’t respond when we need help and ring the on call.” Another staff member told us, “A support worker needed help from the manager, but they said they didn’t have time. Staff may feel disrespected and it’s not what they[manager] said but how they said it to staff.”

Staff were provided with training, but this was mostly delivered online and there were limited opportunities for staff to attend face to face training. The registered manager had not identified or addressed any shortcomings in people’s training. For example, training relating to administering medicines to people.

Staff were not always provided with opportunities to further their professional development by completing additional learning and training.

Staff told us, they felt they could not always speak up and share their feedback. One staff member told us, “I had an individual meeting with the manager, but I felt I couldn’t say what I wanted.” Another staff member told us, “We don’t get much support, and I don’t feel we get appreciated. We all work very hard but get blamed if things go wrong. There is no let’s work together. I can’t speak up; things will get brushed under the carpet.”

Following our feedback the provider felt strongly about addressing the concerns raised and took active steps to address these.